Viruses might mingle in Mecca

Friday

Every year, the single largest gathering on the planet is the annual pilgrimage to Mecca: 2.5 million people from 160 countries packed into a small city in Saudi Arabia for five days.

This year, some will be bringing swine flu.

Saudi authorities, fearing that the hajj could turn their holy city into a petri dish for viral mutations and a hub for spreading a new pandemic wave around the world, are working hard to head that off. They have asked some worshipers, including pregnant women and the elderly, not to make this year's trip, which is scheduled for the last week of November.

"The hajj is a central ritual of Islam, and our country tries to make it easy for everyone to come," said Dr. Ziad A. Memish, the country's assistant deputy minister for preventive medicine. "We've said we won't turn away anyone who arrives at our borders. But we are recommending to other countries whom they should let come."

Although the Saudis have turned to the World Health Organization and other health agencies for help in previous public health threats to the hajj, this year the Centers for Disease Control and Prevention, the U.S. government's lead disease-fighting agency, is more deeply involved because it has so much experience with this new flu strain. Consultants for the centers have gone back and forth to Riyadh, flu experts at American medical schools have been called in and the U.S. Navy's medical laboratory in Cairo is preparing to help with any complex flu testing that is beyond what Saudi laboratories can do.

While religious pilgrimages feed the souls of those who attend, they often endanger the bodies. There have been several outbreaks of meningitis in Mecca since 1987, and in 2004, Muslim pilgrims spread polio from northern Nigeria across Africa to Saudi Arabia and from there outward to Yemen and Indonesia.

In July 2008, about 200,000 young Catholics from all over the world converged on Sydney, Australia, for World Youth Day, attended by the new pope, Benedict XVI, during the Southern Hemisphere's winter. There was a major flu outbreak, and a Tamiflu-resistant strain of seasonal flu established itself and then spread to the Northern Hemisphere, including to the United States, last winter.

The Saudis reacted because this is the first pandemic flu since 1968. Any new flu carries the risk of gene-swapping that can form mutant viruses, and this one has swine and avian genes that, before April, had never been seen in humans. Both the new strain and seasonal flus will be circulating, increasing the risk of flus mixing in Mecca.

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